Brief description of study

Haemorrhoids have, in literature, extremely high ranges of prevalence, 4,4% to 36% and there
is a debate on the best treatment for III degree hemorrhoids. The Stapled Hemorrhoidopexy is
indicated in grade III haemorrhoids due to its advantages vs. other techniques in pain
reduction and time before resume of normal activity. The new technique of Doppler guided
trans-anal arterial ligation (THD) appear to be another important therapeutic tool thanks to
its scarce complications, the minimally invasive procedure and efficacy of the short term
results. The rationale of the two surgical techniques is different: in fact, the Stapled
Hemorrhoidopexy is based on the hypothesis that the mucosal and sub/mucosal resection and
stapling can cure the prolapse, etiologic factor of haemorrhoids; on the other hand, the
interruption of the arterial inflow of hemorrhoids by THD reduces hemorrhoidal tissue." Aim
of this study is to compare 2 techniques: The doppler guided transanal haemorrhoidal
dearterialisation with the THD device and the stapled Haemorrhoidopexy (according to Longo)
for III degree (Goligher) haemorrhoid, not regarding the number of prolapsed piles

Detailed Study Description

After informed consent 284 patients with III degree hemorrhoids from 10 colorectal units
will be randomized into two groups: stapler vs doppler guided transanal hemorrhoidal
dearterialisation with the THD device.The early and long term outcome, as well as other
secondary outcomes (costs, return to work and degree of satisfaction) will be recorded and
compared.